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When Does an Underbite Need Surgery?

July 29th, 2021

When does an underbite need surgery? The short answer is: when Dr. Richard E. Dunn and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

  • First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

  • What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

  • Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

  • Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

  • Can my orthodontist treat my underbite?

Dr. Richard E. Dunn will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Visalia, CA office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

  • What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

  • What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

  • How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Richard E. Dunn to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

  • So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Richard E. Dunn and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.

Adults and Braces

July 22nd, 2021

Nowadays, many adults are taking advantage of getting straighter teeth with braces. Dr. Richard E. Dunn and our team love to help patients create the dazzling, confident smile they’ve always wanted.

Our adult patients usually fall into two categories: some had braces in the past but didn’t wear their retainers, while others are brand-new to wearing braces. Either way, both groups want the same thing: straighter teeth and a beautiful smile!

You will have several options for getting braces, depending on your financial situation and how quickly you would like your treatment to finish. Traditional metal braces are a less-expensive option and can help people who have severely crooked teeth. But many adults may not prefer this option because they dislike the appearance of metal brackets.

If you’re concerned about how you’ll look, we offer clear ceramic braces that aren’t as visible. These are more expensive than metal braces, and patients need to be careful with colored drinks that can stain them, such as coffee or red wine.

Another popular option is a clear aligner treatment called Invisalign®. This type is practically invisible; it uses a series of aligners that are customized to fit your teeth. The process of straightening your teeth can last anywhere from three to 18 months. For people who have extreme bite problems or crowded teeth, a different method may work better.

Don’t hesitate to call our Visalia, CA office today to set up a consultation. Dr. Richard E. Dunn will help you choose the best option so you can be on your way to a straighter, more confident smile!

Ceramic Braces

July 14th, 2021

Congratulations! You have made the decision to get orthodontic treatment at our Visalia, CA office. Now it’s time to choose among your various appliance options. Traditional metal brackets and wires, lingual braces, a series of aligners—they all have positives to recommend them. And for some people, ceramic braces are the clear favorite.

Ceramic braces work like regular metal braces. Brackets are bonded to the front of each tooth, and rubber bands surrounding the brackets hold the arch wire that gradually moves the teeth into alignment.

Ceramic braces, however, use brackets made of clear or tooth-colored ceramic or porcelain which blend beautifully with the color of your tooth. The elastic ligatures, or rubber bands, can be chosen to match the brackets or your enamel. There are self-ligating ceramic brackets which don’t use bands at all. Technology is even working on ways to make the arch wire less visible! The end result is braces that are almost undetectable.

If you want a less obvious appliance for professional or personal reasons, talk to us about ceramic braces. As always, there are other factors to consider before you decide, which we will be happy to discuss with you.

  • Ceramic brackets are very strong, but they are still more brittle than the metal model. If you play a contact sport, these might not be for you. (But whatever braces you choose, please wear a mouthguard when playing sports.)
  • Ceramic braces might not be ideal depending on the amount of alignment and bite correction that is needed. They might also take a bit more time to bring your teeth into alignment. We will be able to tell you if ceramic braces will work for you and if they might require a longer period to move your teeth to their perfect position.
  • Brackets can sometimes be somewhat larger (though this isn’t always the case), and, because they can be abrasive, are often recommended for upper teeth only. This way, the lower teeth will not impact, or be impacted by, contact with the upper teeth.
  • Oral hygiene can trickier with ceramic braces. Although today’s brackets aren’t as prone to staining, you still need to be careful to brush away the plaque that can accumulate around the brackets. And the bands are susceptible to staining by the usual suspects—coffee, tea, colas, blueberries, or any strongly colored food or beverage.
  • Costs will differ depending on the treatment method you choose. Talk to us about cost comparisons with other orthodontic treatments.

Ceramic braces, because they are so much less visible, are a popular orthodontic option, especially for older teenagers and adults. If you are interested, talk to Dr. Richard E. Dunn about this effective way to straighten your teeth—discreetly. Ceramic might be the clear solution for creating your lasting, beautiful smile.

Take Me Out to the Ball Game

July 7th, 2021

You’re going to the game! And no matter which sport you follow, there’s so much to enjoy—the best athletes, exciting play, hometown pride—and those delicious concession stands! But if you’re wearing braces, your team spirit might be flagging. Here are a few ideas to help keep your food choices out of foul territory.

You know that you should avoid the foods that can damage braces or stick around your wires and brackets. This means any snacks that are sticky, chewy, hard, or crunchy are benched. So most of the traditional game foods—peanuts, popcorn, nachos, licorice—are just not safe for traditional metal or ceramic braces. Let’s save those for next season.

So what is on the program? You still have many great choices.

  • Ice Cream. A favorite that’s easy on your braces (no nuts or caramel, please). If you want a healthier option, try frozen yogurt or a smoothie.
  • Hearty Snacks. Pretzels and pizza can be too thick and chewy. Go for the mac and cheese, chili, or deli meats on soft bread. And remember, small bites! Check with us to see if hamburgers and hot dogs are safe for your braces.
  • Soft Candies and Cookies. Licorice, caramels, and crunchy cookies are out, but soft chocolate bars and moist, tender cookies are still on the menu.
  • Sodas and sports drinks can create a sugary and/or acidic environment which can damage enamel over time. If you do indulge, try to rinse with water ASAP.

Stadium and arena menus contain a lot of starches and sugars, which stick to braces and fuel cavity-causing bacteria. So it’s best to go easy on the snacks. But you don’t have to give up a half-time treat entirely—just enjoy in moderation and be sure to brush thoroughly when you get home.

If you wear clear aligners, your choices are simpler. You can remove your aligners, eat normally, and clean your teeth thoroughly before replacing them. But one flag on this play—remember that you’re supposed to wear your aligners for a set number of hours each day. You don’t want to be putting your treatment behind schedule if the game goes into triple overtime. Keep your eye on the clock, and you should be fine.

Dr. Richard E. Dunn and our Visalia, CA team are always happy to recommend the best food options for your individual orthodontic treatment, and we can help you select a roster of safe and healthy choices. You might miss out on a few of your favorite sports snacks right now, but let’s remember the true fan’s motto: There’s always next year! Taking care of your braces and teeth means faster treatment and healthier teeth. Your All-Star smile will be worth it!

Richard E. Dunn, DDS, MS (559) 625-3030
101 W. Tulare Ave
Visalia, CA 93277